How is Heart Failure defined

As been explained in the webpage of www.dilseindia.org, I found the article written by the said Author indeed very informative and I would like to share with all my friends ......

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Heart failure is a condition in which the heart has lost the ability to pump enough blood to the body's tissues. With too little blood being delivered, the organs and other tissues do not receive enough oxygen and nutrients to function properly. In some cases, the heart can’t fill with enough blood. In other cases, the heart can’t pump blood to the rest of the body with enough force. Some people have both problems. Heart failure is almost always a chronic, long-term condition, although it can sometimes develop suddenly. The condition may affect the right side, the left side, or both sides of the heart. Right-sided heart failure means the right ventricle of the heart loses its pumping function. Left-sided heart failure means the heart's ability to pump blood forward from the left side of the heart is decreased. The left side of the heart normally receives blood rich in oxygen from the lungs and pumps it to the remainder of the body. Heart failure is often classified as either systolic or diastolic. Systolic heart failure means that your heart muscle cannot pump, or eject, the blood out of the heart very well. Diastolic heart failure means that your heart's pumping chamber does not fill up with blood. The most common cause of heart failure is coronary artery disease, a narrowing of the small blood vessels that supply blood and oxygen to the heart. Heart failure can also occur when an illness or toxin weakens the heart muscle or changes the heart muscle structure. Such events are called cardiomyopathies. There are many different types of cardiomyopathy. Other heart problems that may cause heart failure are : Congenital heart disease Heart valve disease Some types of abnormal heart rhythms (arrhythmias) Diseases such as emphysema, severe anemia, hyperthyroidism, or hypothyroidism, may cause or contribute to heart failure

What are the symptoms ?

Heart failure can be chronic — meaning your condition is ongoing — or acute, meaning your condition has started suddenly. Chronic heart failure symptoms Shortness of breath (dyspnea) when you exert yourself or when you lie down Fatigue and weakness Swelling (edema) in your legs, ankles and feet Rapid or irregular heartbeat Reduced ability to exercise Persistent cough or wheezing with white or pink blood-tinged phlegm Swelling of your abdomen (ascites) Sudden weight gain from fluid retention Lack of appetite and nausea Difficulty concentrating or decreased alertness

Acute heart failure symptoms Symptoms similar to those of chronic heart failure, but more severe and start or worsen suddenly Sudden fluid buildup Rapid or irregular heartbeat (palpitations) Sudden, severe shortness of breath and coughing up pink, foamy mucus Chest pain, if your heart failure is caused by a heart attack

Surgery and medical devices

In some cases, doctors recommend surgery to treat the underlying problem that led to heart failure. Some treatments being studied and used in certain people include

Coronary bypass surgery

If severely blocked arteries are contributing to your heart failure, your doctor may recommend coronary artery bypass surgery. In this procedure, a vein from your leg, arm or chest replaces a blocked vein in your heart to allow blood to flow through your heart more freely.

Heart valve repair or replacement

If a faulty heart valve causes your heart failure, your doctor may recommend repairing or replacing the valve. The surgeon can modify the original valve (valvuloplasty) to eliminate backward blood flow. Surgeons also can repair the valve by reconnecting valve leaflets or by removing excess valve tissue so that the leaflets can close tightly. Sometimes repairing the valve includes tightening or replacing the ring around the valve (annuloplasty). Valve replacement is done when valve repair isn't possible. In valve replacement surgery, the damaged valve is replaced by an artificial (prosthetic) valve.

Implantable cardioverter-defibrillators (ICDs)

An ICD is a device implanted under the skin and attached through the veins in your chest to your heart with small wires. The ICD monitors the heart rhythm. If the heart starts beating at a dangerous rhythm, or if your heart stops, the ICD tries to shock it back into normal rhythm.

Cardiac resynchronization therapy (CRT) or biventricular pacing

A biventricular pacemaker sends timed electrical impulses to both of the heart's lower chambers (the left and right ventricles), so that they pump in a more efficient, coordinated manner. As many as half the people with heart failure have problems with their heart's electrical system that cause their already-weak heart muscle to beat in an uncoordinated fashion. This inefficient muscle contraction may cause heart failure to worsen. Often a biventricular pacemaker is combined with an ICD for people with heart failure.

Heart pumps (left ventricular assist devices, or LVADs)

These mechanical devices are implanted into the abdomen or chest and attached to a weakened heart to help it pump. Doctors first used heart pumps to help keep heart transplant candidates alive while they waited for a donor heart. LVADs are now sometimes used as an alternative to transplantation. Implanted heart pumps can significantly extend and improve the lives of some people with severe heart failure who aren't eligible for or able to undergo heart transplantation or are waiting for a new heart

Heart transplant

Some people have such severe heart failure that surgery or medications don't help. They may need to have their diseased heart replaced with a healthy donor heart. Heart transplants can dramatically improve the survival and quality of life of some people with severe heart failure. However, candidates for transplantation often have to wait months or years before a suitable donor heart is found. Some transplant candidates improve during this waiting period through drug treatment or device therapy and can be removed from the transplant waiting list.

Prevention

The best way to prevent heart failure is to : Lower your risk of getting heart disease by making lifestyle changes; Control certain health problems, such as high blood pressure and diabetes; To reduce your risk : Don't smoke. If you smoke, quit. Smoking greatly increases your risk for heart disease. Avoid secondhand smoke too; Lower your cholesterol. If you have high cholesterol, follow your doctor's advice for lowering it. Eating a heart-healthy diet-such as the TLC diet -exercising, and quitting smoking will help keep your cholesterol low; Control your blood pressure. High blood pressure raises your risk of getting heart disease. Studies show that lowering blood pressure to normal levels in people who have high blood pressure could reduce the cases of heart failure by half. Exercising, limiting alcohol, and controlling stress will help keep your blood pressure in a healthy range; Get regular exercise. Exercise will help control your weight, blood pressure, and stress. Controlling these things will help keep your heart healthy. Try to do activities that raise your heart rate. Aim for at least 2½ hours of moderate exercise a week.3 One way to do this is to be active at least 10 minutes 3 times a day, 5 days a week. Talk to your doctor before starting an exercise program; Control diabetes. Take your medicines as directed, and work with your doctor to make a diet and exercise plan to control diabetes; Limit alcohol. If you drink alcohol, drink moderately. This means no more than 2 drinks a day for men and 1 drink a day for women. Heavy consumption of alcohol can lead to heart failure.

Complications Irregular heart rhythms (can be deadly) Pulmonary edema Total heart failure (circulatory collapse)

OCD A to Z U is For Unique Fears

U was a hard one at first, but I remembered how many times I've encountered concern about having unique fears on the OCD Support Yahoo group, and in my own OCD support group, and in comments and emails from readers. OCD is as diverse as the people who suffer from it, with obsessions and compulsions that can be as unique as a fingerprint, but sharing the commonality of being human, and suffering from this disorder.

• There is a despair that you are the only person who has a unique set of symptoms, and therefore maybe it's not really OCD, but something more dire.

• There is fear that if no one else has these symptoms, no therapist will be able to help.

• There is a visceral panic that the very bizarreness of your thoughts is a sign about you as a person, and your worth.

These fears are compounded by the lack of therapists trained in Exposure and Response Prevention Therapy, and who have sufficient experience treating OCD. For an inexperienced therapist, OCD symptoms may sound unique, but to someone who is familiar with OCD, they can see the underlying thread, the essence of the disorder underneath the permutations. This is not the same as finding a perfect therapist, and if you are like me and have perfectionist OCD, this can make it difficult to accept that all therapists are imperfect, even good ERP ones.

OCD is strangely unknown. Yes, there are whole reality TV shows devoted to it, but when faced with a patient in their office, it is all too easy for therapists to be distracted by the individual symptoms, trying to figure them out, trace their causes. This is what works in therapy for many other problems. I believe that recognizing OCD can be learned. My therapist didn't start out as an ERP therapist, but his OCD patients weren't getting better, and he wanted to learn more, and he educated himself, and now wants to go out and spread the word to his colleagues through continuing education and conferences.

It's like when someone mentions something and then you see it everywhere, but before then, you never noticed. Here is my prescription for therapists who want to learn more:

• Read Jonathan Grayson's Freedom From OCD to get the basics of ERP
  
• Read messages on OCD Support, and PureO, and Anxiety Zone. Scan at least a year's worth of threads, and note the recurring themes(but you do not need to replicate my compulsive reading of all the archives of OCD Support. . .)
  
• Go to the IOCDF Conference and or/become a member of IOCDF and read the newsletter. If you are therapist check out the Behavior Therapy Training Institute. They the IOCDF also has a list of treatment providers.
  

My prescription for someone suffering from a fear of having unique, untreatable symptoms would be much the same as for therapists, along with the knowledge that this is OCD's mode of operation to latch onto whatever is important to you, whatever your unique life experiences. For me, obsessing about obsessing is a struggle, so worrying that my OCD wasn't OCD, became one of my key themes, and I had to practice doing imaginal exposures, listening to scripts about how my OCD might really be something else, or untreatable, while going ahead with my treatment.

What Fascia is and Why You Should Care

by Baxter

Chiara Guerrieri by Melina Meza

Over the course of the last four years, we have written—sometimes at length—about various important components of our physical bodies, including muscles, tendons, ligaments, spinal discs, cartilage, nerves, and blood vessels. But we have only made passing reference to another ubiquitous component that in many ways holds everything together: fascia. Fascia falls into the group of specialized body tissues known as “connective tissue,” which is the material that lies between, cushions, spaces out, provides shape to and surround many other parts of our bodies. Unlike many other non-connective tissues of the body, fascia is made up of a “matrix” of material, almost like a gel, that contains fewer cells in proportion to its overall structure, making it both pliable and supportive. The cells in fascia are called fibroblasts, and they produce a tough fibrous protein called collagen, which gives the fascia shape and strength. 

Fascia is like a specialized kind of plastic wrap that:

• Surrounds all organs, every muscle, and individual muscle fibers
• Narrows from surrounding muscles into the tendons
• Wraps around every bone (the periosteum)
• Is the layer of tissue right under the skin (the dermis)
• Surrounds blood vessels and nerves

So our fascia creates containers that contribute to and support the shapes of other structures. And when one layer of fascia is adjacent to another layer, the fascia permits some sliding, gliding movements between the structures, such as muscle and organs, that it encloses, which contributes to your ease of movement. There are also connections between fascia along the long axis of our body, creating interconnected strings of tissue that can hold tension and transmit force. This contributes to our ability to maintain our overall structure and upright posture, and when we move and change position. For example, when we bend forward, there is an increase in the tension along the myofascial plane on the back of the body, while the one on the front becomes more slack, like an extension of what you would see at an individual joint, but now affecting the whole body. Sounds like amazing stuff!

Knowing something about fascia is helpful for your asana practice because just as a muscle can shrink and tighten from environmental factors such as inactivity or habitual ways of standing and sitting, the fascia that surrounds the muscle can suffer the same fate. It turns out that when you are trying to stretch a muscle and create a longer resting muscle length, you are also stretching the fascia that surrounds the muscle. And because fascia not only surrounds individual muscles, but also forms fascial planes (connections) that run for longer distances through the body, the planes can also become tight and restricted. For example, if the myofascial connection from the outer ankle up to the side of the skull became tight, it could cause a subtle or not subtle side-bending of the body. In this case, focusing on stretching the entire side body, such as with dynamic or static New Moon pose, (Parsva Urdhva Hastasana) away from tight side could be an effective way to address that area. This goes beyond the more limited way of looking at one isolated muscle as the cause of tightness, and takes in the greater reality of our myofascial system. 

Although these planes can be lengthened via stretching and movement, it takes take them longer then individual muscles to reset to a longer length—from 3-6 months. In fact, Tom Myers, an expert who studies fascia and fascial lines, recommends that we start looking at these longer myofascial connections instead of individual muscles when we want to release tension and stiffness in our bodies. For example, if we notice that our posture is stooped forward and we think initially that it is mostly a shortness and tightening of the long, vertical abdominal muscles pulling our chest forward and down, we might instead consider that our stooped posture is actually a restriction in the long myofascial connection that runs the entire front length of our body. Our approach to improving our posture might then focus on stretching that entire front fascial connection—from the front neck to the legs and ankles—via a series of active and passive backbends, rather than just stretching the abdominal muscles. Because so many yoga poses address the entire length and circumference of the body, yoga is particularly good for stretching both muscle and fascia. 

So, understanding a bit about fascia expands your overall understanding of the complexity of your body, taking you beyond simply considering individual muscles or joints and expanding to include changing your fascia and fascial connections. Knowing that it may take longer to see significant change in areas of stiffness due to fascial tightness may help you to be more patient with your body. Because slow, gradual, longer stretches, where your muscles finally lengthen after you overcome the stretch reflex, begin to address the fascial tightness, I recommend slow, longer holds, working up to 90 seconds holds, to address both muscle and fascia, and practicing this way consistently. 

Our past recommendations here at YFHA to establish a regular home practice and to stick with it over the long haul, with a patient attitude, will serve you well as you attempt not only to release localized stiffness and restriction in certain muscles, but also to achieve more global improvement in your myofascial connections. 

Note: For those who wish to learn more about these myofascial connections, which run along the front, sides, and back of the body, both near the surface of the body and deeper, and also include spiral connections, consider reading Tom Myers’ book Anatomy Trains. 

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OCD A to Z P is For Perfectionism

Perfectionism is a big part of my OCD, and one of the biggest obstacles to doing Exposure and Response Prevention Therapy(ERP), because of looking for "perfect" ways to do it. I've had some readers query whether I actually have Obsessive Compulsive Personality Disorder(OCPD) rather than OCD, because of all the posts I've written about perfectionism. My understanding, via my therapist, is that there is an element of finding perfectionism to be pleasing rather than painful in the case of OCPD. My impulse is to look this up, but I've looked it up in the past, and I know the familiar trap of wanting to get everything just right.

Early on I decided that I could be loved by my family only if I never made a mistake again, and I strived to always to get things right on the first try, or I would procrastinate ever trying at all, in order to avoid failure and the feared consequence of becoming worthless and unloveable. Avoidance became one of my major compulsions, as OCD got its claws into my fears, ever the vulture circling. The most frustrating aspect was that often I didn't even know what "perfect" was in any given situation, just that whatever I was doing was "imperfect" . It was a moving target, always changing, and if I finally felt "aha, that's it" then my mind would generate some other aspect to make perfect.

It's been a battle accepting that my mind will probably continue to generate thoughts of not being good enough, or done, or finished, or that I've ruined a day, or my life. But I also see that I don't have to jump when these thoughts arrive, scrambling to fix things, make things perfect. Perfection is a corrosive illusion, and all the "Perfectionism is actually an advantage" truisms used to send me into compulsive searching to find out if this was really true, because I could never be wrong, always had to figure things out. But I know from experience that perfectionism is most likely to prevent me from getting things done, keeps me searching for photos on flickr past the first couple pages, or delaying writing posts until I find the "right" topic. I have met amazing readers with OCD through this blog, in all its imperfections, and offered some hope, and that is what keeps me going.

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What is DEET

[Extracted from Wisegeek.com]

DEET (N,N-diethyl-meta-toluamide) is arguably the most widely recommended active ingredient in insect repellents. Proven effective, DEET does not kill insects. Instead it prevents biting insects like mosquitoes and ticks from zeroing in on your skin.

Biting insects follow the scent of carbon dioxide gas to find a meal. Skin and breath naturally give off a carbon dioxide. By spreading a small amount of DEET on exposed skin and applying it to external clothing, insects cannot readily locate the source of the carbon dioxide.

Each year about 30 million Americans use products containing DEET. Its greatest benefit is in repelling disease-bearing insects, like deer ticks that can transmit Lyme disease, and mosquitoes that can transmit encephalitis and West Nile virus. It also benefits those exposed to insects that might be carrying malaria, dengue fever and other diseases.

Studies found that a concentration of 23.8% DEET successfully repelled mosquitoes for approximately 5 hours -- three times longer than the next leading product. It also found that higher concentrations extended that protection time. Other studies indicate ticks are repelled for 3-8 hours, depending on the concentration of DEET used.

The Environmental Protection Agency (EPA) registered DEET for public use in 1957. It re-assessed DEET in 1998 to ensure that it meets modern safety standards. It concluded that DEET is very safe when used as directed.

Older products containing DEET may have had misleading labels that included a child safety claim for concentrations of 15% or less. When the EPA reassessed DEET in 1998 it mandated that the child safety claim be discontinued, finding that the concentration of DEET was irrelevant; following directions was deemed to be critical. Concentrations of 100% DEET are safe for children when used as directed, while lower concentrations of 15% or less do not guarantee safety if the product is misused.

DEET has over 50 years of scientific research behind it, and the efficacy of widespread public use for several decades. This makes it the most vigorously tested repellent on the market. Although safe, make sure to read and follow all labels instructions that come with any product containing DEET.

[Pictures of products, extracted from Off Insect Repellent's Website]

5-15% DEET			OFF!® FamilyCare Insect Repellents (pump-spray, aerosol and towelette) Contain 5-15% DEET Ideal for the backyard or playground Provides protection for up to 2 hours (5-7% DEET) or up to 6 hours (15% DEET) against mosquitoes
15-25% DEET			OFF! Active® (pump-spray and aerosol) Contain 15% or 25% DEET Sweat resistant Ideal for family sports Provides protection for up to 6 hours (15% DEET) or up to 8 hours (25% DEET) against mosquitoes
25% DEET			OFF! Deep Woods® Insect Repellents (pump-spray, aerosol and towelette) Contain 25% DEET Effective in wooded areas Ideal for camping, hiking, and fishing Provides protection for up to 8 hours against mosquitoes
30% DEET			OFF! Deep Woods® Sportsmen Insect Repellents (pump-spray and aerosol) Contain 25% or 30% DEET Effective in intense bug-biting situations Ideal for hunting, hiking, fishing, and camping Provides protection for up to 8 hours against mosquitoes
98.25% DEET			OFF! Deep Woods® Sportsmen Insect Repellent I (pump-spray) Contains 98.25% DEET Easy to apply Convenient-to-carry size Provides protection for up to 10 hours against mosquitoes